Articlehybrid2017

Crowding out of solidarity? Public health insurance versus informal transfer networks in Ghana

57 citations0/0 files storedWorld Development

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Healthcare Systems and Reforms Poverty, Education, and Child Welfare Agricultural risk and resilience

Abstract

This paper delivers empirical evidence on how transfers that serve as an informal insurance mechanism are affected by a formal and country-wide health insurance scheme. Using the fifth and fourth waves of the Ghanaian Living Standard Household Survey, we investigate the extent to which the implementation of the National Health Insurance Scheme affects health-related outcomes and making or receiving informal transfers. Our findings suggest that there is a reduction of out-of-pocket expenditures for health services and a significant crowding out of informal transfers. We conclude that the provision of formal health insurance does not only relieve ill individuals from out-of-pocket expenditures, but also their network partners from making informal transfers.

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References

1997The analysis of household surveys 2011Nudging Farmers to Use Fertilizer: Theory and Experimental Evidence from Kenya 2008Policies Designed for Self-Interested Citizens May Undermine "The Moral Sentiments": Evidence from Economic Experiments 2011Handbook of Social Economics 2015Institutions, Social Norms and Economic Development 2009Spousal Control and Intra-Household Decision Making: An Experimental Study in the Philippines 2009Directed Altruism and Enforced Reciprocity in Social Networks *2010Ghana's national health insurance scheme in the context of the health MDGs: an empirical evaluation using propensity score matching

Cited by

2020The Social Value of Health Insurance: Results from Ghana 2016Formal Insurance and the Dynamics of Social Capital: Experimental Evidence from Uganda 2019Linking Social Protection Schemes: The Joint Effects of a Public Works and a Health Insurance Programme in Ethiopia 2020Do public program benefits crowd out private transfers in developing countries? A critical review of recent evidence

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